This invention relates to medical devices and procedures in general, and more particularly to medical devices and procedures for reconstructing a ligament.
A ligament is a piece of fibrous tissue which connects one bone to another.
Ligaments are frequently damaged (e.g., detached or torn or ruptured, etc.) as the result of injury and/or accident. A damaged ligament can impede proper motion of a joint and cause significant pain.
Various procedures have been developed to repair or replace a damaged ligament. The specific procedures used depend on the particular ligament which is to be restored and on the extent of the damage.
One ligament which is frequently damaged as the result of injury and/or accident is the anterior cruciate ligament (ACL). Looking now at FIG. 1, the ACL 5 extends between the top of the tibia 10 and the bottom of the femur 15. A damaged ACL can cause instability of the knee joint and cause substantial pain and arthritis.
Numerous procedures have been developed to restore the ACL through a graft ligament replacement. In general, and looking now at FIG. 2, these ACL replacement procedures involve drilling a bone tunnel 20 through tibia 10 and up into femur 15. Then a graft ligament 25, consisting of a harvested or artificial ligament or tendon(s), is passed through the tibial portion 30 of tunnel 20 (sometimes referred to as xe2x80x9cthe tibial tunnelxe2x80x9d), across the interior of the joint, and up into the femoral portion 35 of tunnel 20 (sometimes referred to as xe2x80x9cthe femoral tunnelxe2x80x9d). Then a distal portion of graft ligament 25 is secured in femoral tunnel 35, and a proximal portion of graft ligament 25 is secured in tibial tunnel 30.
One object of the present invention is to provide improved apparatus for positioning the graft ligament in the bone tunnel and/or for securing the graft ligament within the bone tunnel,.
Another object of the present invention is to provide an improved method for reconstructing a ligament.
These and other objects of the present invention are addressed by novel apparatus and method for reconstructing a ligament.
In one preferred form of the invention, the invention comprises a crosspin for supporting a graft ligament in a first bone tunnel formed in a bone, by positioning the crosspin in a second bone tunnel extending transverse to, and intersecting, the first bone tunnel, the crosspin comprising: a shaft having a distal portion, an intermediate portion, and a proximal portion; the distal portion comprising attachment means for attaching a flexible member to the shaft; the intermediate portion comprising screw threads; and the proximal portion including driver engagement means for engagement by a driver adapted to turn the shaft; whereby the crosspin may be drawn through the second transverse bone tunnel by a flexible member attached to the distal portion by the attachment means, and the crosspin may have its screw threads turned into the bone by a driver engaged with the engagement means.
In another form of the invention, the invention comprises a crosspin for supporting a graft ligament in a first bone tunnel formed in a bone, by positioning the crosspin in a second bone tunnel extending transverse to, and intersecting, the first bone tunnel, the crosspin comprising: a shaft having a distal portion, an intermediate portion, and a proximal portion; the distal portion having a flexible member attached thereto; the intermediate portion comprising screw threads; and the proximal portion including driver engagement means for engagement by a driver adapted to turn the shaft; whereby the crosspin may be drawn through the second transverse bone tunnel by the flexible member, and the crosspin may have its screw threads turned into the bone by a driver engaged with the engagement means.
In another form of the invention, the invention comprises a crosspin for supporting a graft ligament in a first bone tunnel formed in a bone, by positioning the crosspin in a second bone tunnel extending transverse to, and intersecting, the first bone tunnel, the crosspin comprising: a cannulated shaft having a distal portion, an intermediate portion, and a proximal portion; the intermediate portion comprising screw threads; and the proximal portion including driver engagement means for engagement by a driver adapted to turn the shaft; whereby the crosspin may be positioned in the second transverse bone tunnel by loading the crosspin on, and moving the crosspin along, the flexible member, and the crosspin may have its screw threads turned into the bone by a driver engaged with the engagement means.
In another form of the invention, the invention comprises a method for securing a graft ligament in a bone tunnel, wherein the graft ligament comprises a bone block and a ligament attached to the bone block, the method comprising the steps of: (1) forming a first bone tunnel in a bone, and forming a second bone tunnel in the same bone, the second bone tunnel being transverse to, and intersecting, the first bone tunnel; and (2) positioning the graft ligament in the first bone tunnel, and positioning a crosspin in the second transverse bone tunnel, so that the bone block is positioned in the first bone tunnel on one side of the crosspin and the ligament is positioned in the first bone tunnel so that the ligament extends past the crosspin to the other side of the crosspin, whereby when tension is applied to the end of the ligament opposite from the bone block, the bone block will be stopped from movement past the crosspin by engagement of the bone block with the crosspin.
In another form of the invention, the invention comprises a method for securing a graft ligament in a bone tunnel, wherein the graft ligament comprises a bone block and a ligament attached to the bone block, the method comprising the steps of: (1) forming a first bone tunnel in a bone, and forming a second bone tunnel in the same bone, the second bone tunnel being transverse to, and intersecting, the first bone tunnel; and (2) positioning the graft ligament in the first bone tunnel, and positioning a crosspin in the second transverse bone tunnel, so that the bone block is positioned in the first bone tunnel on one side of the crosspin, and the ligament is positioned in the first bone tunnel so that the ligament extends past the crosspin to the other side of the crosspin, loops over the crosspin, and extends past the crosspin back to the first side of the crosspin, whereby when tension is applied to the end of the ligament opposite from the bone block, the bone block will be stopped from movement past the crosspin by engagement of the bone block with the crosspin.
In another form of the invention, the invention comprises apparatus for securing a graft ligament in a bone tunnel, wherein the graft ligament comprises a bone block and a ligament attached to the bone block, the apparatus comprising: a plate having a body with an opening formed therein, and a plurality of pointed legs extending therefrom, the body being sized to receive the bone block between the pointed legs; and a crosspin comprising a shaft and screw threads formed thereon, the shaft being sized to pass through the opening such that the crosspin may secure the bone block to the wall of the bone tunnel.
In another form of the invention, the invention comprises a method for securing a graft ligament in a bone tunnel, wherein the graft ligament comprises a bone block and a ligament attached to the bone block, the method comprising the steps of: (1) forming a first bone tunnel in a bone, and forming a second bone tunnel in the same bone, the second bone tunnel being transverse to, and intersecting, the first bone tunnel, and providing a plate having a body with an opening formed therein, and a plurality of pointed legs extending therefrom, the body being sized to receive the bone block between the pointed legs, and providing a crosspin comprising a shaft and screw threads formed thereon; (2) positioning the graft ligament and the plate in the first bone tunnel, and positioning the crosspin in the second transverse bone tunnel, so that the crosspin extends through the opening in the plate and urges the plate against the bone block, whereby the graft ligament will be secured in the first bone tunnel.